Life expectancy for children with malignant diseases has been dramatically improved during the last decade. Whereas many factors have been contributory, the two largest are increased numbers of interested, knowledgeable people caring for these children and improvement in available therapies. The University of Arkansas Medical Center (UAMC) located in the center of this rural state, is the only diagnostic and treatment center freely available to all children in the state. Additionally, it is the only teaching training research center in the state for all medical and paramedical personnel. Collaboration in the Southwest Oncology Group enables the investigators here at the University to contribute to the improvement of the available therapies for children with malignant disease by participating in design and execution of therapy protocols for these diseases. The increased values of chemotherapeutic trials on a group basis as compared to single institution trial has recently been validated in a SOG pediatric ALL study. The knowledge gained through these studies and through intellectual exchanges with other investigators improves the local expertise and provides better teaching and training for other medical personnel. Such collaborations generate a contagious interest and enthusiasm which then helps to generate the same interest and enthusiasm in medical students, resident house officers and in the patient's family physician for the care of these children. The patients come to the UAMC from all over the state. As we use these patients for teaching all types of medical personnel, we are developing a network of knowledgeable and experienced workers throughout the state. This permits the child to receive optimal care when he is at home with the knowledge that he will be referred for use of the increased facilities at UAMC when his disease course requires such support.